Exercise in pregnancy reduces adverse effects of gestational diabetes

Regular moderate-intensity exercise during the second half of pregnancy can improve fetal and maternal outcomes for women who develop gestational diabetes mellitus (GDM), show study findings, although the team notes that regular exercise did not significantly reduce the risk for developing GDM per se.

As reported in the British Journal of Sports Medicine, Jonatan Ruiz (University of Granada, Spain) and colleagues assessed the benefits of an intervention promoting moderate exercise three times a week (50-55 min per session) from weeks 10-12 to weeks 38-39 of pregnancy versus usual care for 510 women who were initially healthy and diabetes free.

According to the World Health Organization (WHO) criteria, 19.5% of the exercise group and 28.0% of the control group developed GDM, while 13.8% and 14.7% of the respective groups developed GDM according to the International Association for Diabetes in Pregnancy Study Group (IADPSG). Both these between group differences were nonsignificant.

However, GDM (WHO criteria)-associated risk for macrosomia, a common fetal complication associated with the condition, was reduced by a significant 58% in the exercise versus the control group. Women with GDM in the exercise group had a 1.76-fold and those in the usual care group a 4.22-fold increased risk for having a child with macrosomia compared with those without GDM.

"This finding is of public health relevance because fetal macrosomia is associated with significant maternal and neonatal morbidity," write the authors.

Compared with women who did not develop GDM, those with GDM in the exercise group were also a significant 34% less likely to require an acute or elective cesarean delivery than those in the control group, at respective risk increases of 1.30 versus 1.99 fold.

"We believe that this result is also of potential clinical relevance owing to the maternal complications associated with cesarean delivery such as infection, excessive blood loss, respiratory complications, reactions to anesthesia, longer hospitalization periods, as well as higher medical cost," says the team.

They note that gestational age was similar in both groups and that women in the exercise group gained approximately 12% less weight than those in the control group, regardless of whether they developed GDM.

"Taken together, our findings provide further support for the benefits of moderate-intensity exercise… and for promoting supervised exercise interventions during pregnancy," conclude Ruiz et al.

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